{"id":3334,"count":25,"description":"Kategorie hepatitidov\u00fdch l\u00e9k\u016f na MedsBase zahrnuje peror\u00e1ln\u00ed antivirotika pro dva odli\u0161n\u00e9 typy chronick\u00fdch virov\u00fdch infekc\u00ed jater, kter\u00e9 lze skute\u010dn\u011b l\u00e9\u010dit tabletami \u2014 chronick\u00e1 hepatitida B (HBV)<\/strong> a chronick\u00e1 hepatitida C (HCV)<\/strong> \u2014 spolu s kombinacemi na b\u00e1zi tenofoviru pou\u017e\u00edvan\u00fdmi jak pro supresi HBV, tak pro profylaxi HIV. Ka\u017ed\u00e1 t\u0159\u00edda l\u00e9\u010div m\u00e1 sv\u016fj vlastn\u00ed c\u00edl, mechanismus a d\u00e9lku trv\u00e1n\u00ed. V\u00fdb\u011br spr\u00e1vn\u00e9ho l\u00e9ku za\u010d\u00edn\u00e1 t\u00edm, \u017ee v\u00edte, kter\u00fd virus l\u00e9\u010d\u00edte, jakou m\u00e1te funkci ledvin a zda jste ko-infikov\u00e1ni HIV.\n\nHepatitida C: 12t\u00fddenn\u00ed l\u00e9\u010dba p\u0159\u00edm\u00fdmi antivirotiky (DAA)\nHCV je jedinou chronickou virovou hepatitidou, kterou lze sou\u010dasnou peror\u00e1ln\u00ed terapi\u00ed vyl\u00e9\u010dit. vyl\u00e9\u010dit<\/em>. P\u0159\u00edm\u00e1 antivirotika (DAA) sou\u010dasn\u011b c\u00edl\u00ed na HCV NS5B polymer\u00e1zu a NS5A replika\u010dn\u00ed komplex. V\u00fdsledkem je trval\u00e1 virologick\u00e1 odpov\u011b\u010f (SVR12) \u2014 HCV RNA nedetekovateln\u00e1 12 t\u00fddn\u016f po posledn\u00ed tablet\u011b \u2014 u 95 % nebo v\u00edce pacient\u016f bez cirh\u00f3zy, kte\u0159\u00ed dosud nebyli l\u00e9\u010deni. L\u00e9\u010dba trv\u00e1 12 t\u00fddn\u016f; po vyl\u00e9\u010den\u00ed nen\u00ed nutn\u00e1 dal\u0161\u00ed antivirov\u00e1 terapie.\n\nHepcinat LP<\/strong><\/a> \u2014 sofosbuvir 400 mg + ledipasvir 90 mg, generick\u00fd Harvoni. Prvn\u00ed volba pro genotypy HCV 1, 4, 5 a 6.\n\n\nHepatitida B: dlouhodob\u00e1 suprese tenofovirem\nNa rozd\u00edl od HCV je chronick\u00e1 hepatitida B v sou\u010dasnosti sp\u00ed\u0161e zvl\u00e1dnutelnou infekc\u00ed ne\u017e l\u00e9\u010ditelnou. \u0160ablona cccDNA uvnit\u0159 infikovan\u00fdch hepatocyt\u016f nen\u00ed eliminov\u00e1na \u017e\u00e1dn\u00fdm peror\u00e1ln\u00edm l\u00e9kem, proto je l\u00e9\u010dba HBV obvykle dlouhodob\u00e1. C\u00edlem je nedetekovateln\u00e9 HBV DNA, norm\u00e1ln\u00ed ALT a prevence cirh\u00f3zy a hepatocelul\u00e1rn\u00edho karcinomu. Dv\u011b formy tenofoviru dominuj\u00ed v doporu\u010den\u00edch (EASL, AASLD, APASL, WHO):\n\nTenvir<\/strong><\/a> \u2014 tenofovir disoproxil fumar\u00e1t (TDF) 300 mg od Cipla. Bezpe\u010dnostn\u00ed data za 20+ let; preferov\u00e1no v t\u011bhotenstv\u00ed.\nTeravir<\/strong><\/a> \u2014 tenofovir disoproxil fumar\u00e1t 300 mg od Cipla, alternativn\u00ed zna\u010dka TDF.\nTenvir AF<\/strong><\/a> \u2014 tenofovir alafenamid (TAF) 25 mg od Cipla, generick\u00fd Vemlidy. Stejn\u00fd aktivn\u00ed metabolit jako TDF, ale ~90% ni\u017e\u0161\u00ed expozice v plazm\u011b: v\u00fdrazn\u011b men\u0161\u00ed toxicita pro ledviny a kosti. Preferovan\u00fd u chronick\u00e9ho onemocn\u011bn\u00ed ledvin, osteopor\u00f3zy, v\u011bku > 60 let nebo p\u0159edchoz\u00ed toxicity TDF.\n\n\nProfylaxe HIV p\u0159ed expozic\u00ed (PrEP) a kombinovan\u00e9 l\u00e9\u010debn\u00e9 tablety\nStejn\u00e1 z\u00e1kladn\u00ed l\u00e1tka tenofovir, kdy\u017e je kombinov\u00e1na s emtricitabinem (FTC), je standardem pro profylaxi HIV p\u0159ed expozic\u00ed \u2014 sni\u017euje riziko n\u00e1kazy HIV o > 99% p\u0159i denn\u00edm u\u017e\u00edv\u00e1n\u00ed podle pokyn\u016f. Tyto produkty jsou uvedeny v t\u00e9to kategorii, proto\u017ee samotn\u00fd TDF je tak\u00e9 \u00fa\u010dinn\u00fd proti HBV; u ko-infekce HBV\/HIV jedna kombinovan\u00e1 tableta pokr\u00fdv\u00e1 oboj\u00ed. Zde jsou skladem t\u0159i zna\u010dkov\u00e9 generick\u00e9 p\u0159\u00edpravky Truvady:\n\nTenvir-EM<\/strong><\/a> \u2014 TDF 300 + FTC 200 od Cipla.\nRicovir EM<\/strong><\/a> \u2014 TDF 300 + FTC 200 od Mylan.\nTenof EM<\/strong><\/a> \u2014 TDF 300 + FTC 200 od Hetero.\n\nDenn\u00ed PrEP, ud\u00e1lostmi \u0159\u00edzen\u00fd re\u017eim 2-1-1 (pouze pro cisgender MSM) nebo kombinovan\u00e1 l\u00e9\u010dba HIV v\u0161echny za\u010d\u00ednaj\u00ed stejnou molekulou. V\u00fdb\u011br mezi t\u0159emi zna\u010dkami je p\u0159ev\u00e1\u017en\u011b o preferenci v\u00fdrobce a dostupnosti; farmakologie je identick\u00e1.\n\nV\u00fdb\u011br mezi mo\u017enostmi\n\n\n\nPot\u0159eba\nDoporu\u010den\u00fd v\u00fdchoz\u00ed bod\n\n\n\nL\u00e9\u010dba hepatitidy C (genotyp 1\/4\/5\/6)\nHepcinat LP, 12t\u00fddenn\u00ed kurz.\nChronick\u00e1 HBV, norm\u00e1ln\u00ed funkce ledvin, v\u011bk 60\nTenvir AF (TAF 25).\nHIV PrEP \u2014 denn\u011b nebo 2-1-1\nTenvir-EM, Ricovir EM nebo Tenof EM (TDF\/FTC).\nKoinfekce HBV + HIV\nKombinace TDF\/FTC \u2014 pokr\u00fdv\u00e1 oboj\u00ed.\n\n\n\nV\u0161echny re\u017eimy pro hepatitidu B a HIV vy\u017eaduj\u00ed vstupn\u00ed vy\u0161et\u0159en\u00ed (HBV DNA nebo HIV RNA, HBeAg\/HBsAg, eGFR, ALT, screening hepatitidy, lipidov\u00fd panel) a pr\u016fb\u011b\u017en\u00e9 odborn\u00e9 sledov\u00e1n\u00ed. L\u00e9\u010dba hepatitidy C tak\u00e9 t\u011b\u017e\u00ed z dohledu hepatologa, zejm\u00e9na pokud je p\u0159\u00edtomna cirh\u00f3za nebo l\u00e9ky interaguj\u00edc\u00ed s DAA. MedsBase dod\u00e1v\u00e1 l\u00e9ky; klinick\u00e9 sledov\u00e1n\u00ed by m\u011blo b\u00fdt zaji\u0161t\u011bno lok\u00e1ln\u011b.","link":"https:\/\/medsbase.com\/cs\/hepatitis-medication\/","name":"L\u00e9ky na hepatitidu","slug":"hepatitis-medication","taxonomy":"product_cat","parent":3223,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3334","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3223"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product?product_cat=3334"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}